Provider Demographics
NPI:1629374459
Name:MESQUITE COUNSELING SERVICE INC
Entity Type:Organization
Organization Name:MESQUITE COUNSELING SERVICE INC
Other - Org Name:REFLECTIONS OF THE HEART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:HARNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LCDC
Authorized Official - Phone:469-964-3162
Mailing Address - Street 1:6174 RAYMOND RD
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-7655
Mailing Address - Country:US
Mailing Address - Phone:469-964-3162
Mailing Address - Fax:469-355-6173
Practice Address - Street 1:6174 RAYMOND RD
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-7655
Practice Address - Country:US
Practice Address - Phone:469-964-3162
Practice Address - Fax:469-355-6173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3378-3379324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility